Fibroblastic sleeve is a common pathophysiological phenomenon characterized by the formation of a mixed fibrous-collagen tissue encasing the outside of venous access devices. Although it nearly always presents asymptomatically, this catheter-related complication represents one of the leading culprits of venous catheters malfunction. Several techniques have been described for the management of dysfunctional catheters secondary to fibroblastic sleeve, including medical therapy, catheter exchange, balloon angioplasty, and percutaneous stripping. However, there is no common consensus for the treatment management in patients who present contraindications to surgical port removal. This report illustrates the case of a port catheter malfunction due to a fibroblastic sleeve in an oncological patient with a high risk of bleeding. This was effectively treated with a minimally invasive stripping technique using an off-label device for mechanical thrombectomy, namely the ClotTriever system (Inari Medical, Irvine, CA).
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http://dx.doi.org/10.1177/11297298241254561 | DOI Listing |
J Vasc Access
December 2024
Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
The fibroblastic sleeve is a structure potentially enveloping any intravascular device. At ultrasound scan, it typically presents as a thin layer of variably echogenic material covering the catheter surface, which usually tends to remain into the vessel after the catheter removal. However, several case reports have documented its migration toward the heart or pulmonary artery after a central venous catheter removal.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
A central venous catheter (CVC) was placed in the left internal jugular vein of a woman in her late 20s, who was admitted to our intensive care unit during the management of her abdominal wall sepsis. Two days later, the patient had pain at the insertion site. Check aspiration revealed the presence of aspirate from all the lumens except the distal lumen.
View Article and Find Full Text PDFBackground and objectives Obesity is a major global health concern linked with increased risk of chronic diseases. This study aimed to assess the levels of fibroblast growth factor 21 (FGF21) in subjects with obesity after gastric sleeve surgery and explore its correlation with lipid and glycemic parameters. Methods This retrospective cohort study included 28 obese male subjects aged 25 to 50 years, undergoing gastric sleeve surgery.
View Article and Find Full Text PDFJ Vasc Access
August 2024
Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Luigi Sacco Hospital, Milan, Italy.
Sci Prog
August 2024
Vascular Access Center, Oncology Center of Agel Nový Jičín Hospital, Nový Jičín, Czech Republic.
Introduction: Persistent withdrawal occlusion (PWO) is a specific catheter malfunction characterized by the inability to withdraw blood through the device. The most common cause of PWO in ports is the presence of a fibroblastic sleeve (FS). If malfunction occurs, medication can be applied incorrectly with the increased risk of complications.
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